The classic risk factors can only in part explain the increased incidence and extent of coronary artery disease. Plasminogen activator inhibitor type-1 (PAI-1), the main human regulator of endogenous fibrinolysis, is considered to be an important cardiovascular risk factor. The article discuss the current knowledge of the PAI-1 importance and role in the in the pathogenesis of atherosclerosis and mechanisms of its synthesis predominantly in patients with coronary artery disease associated with diabetes mellitus type 2. It explaines contributions of PAI-1 to the pathophysiologic links between diabetes mellitus and cardiovascular diseases and shows current therapeutic interventions normalising PAI-1 activity, their beneficial effect on prognosis and course of coronary artery disease.

        Key words: Plasminogen activator inhibitor type-1 (PAI-1) - Atherogenesis - Diabetes mellitus - Hyperinsulinaemia